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A strong pelvic floor is associated with higher rates of sexual activity in women with pelvic floor disorders

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Abstract

Introduction and hypothesis

We evaluated the associations between pelvic floor muscle strength and tone with sexual activity and sexual function in women with pelvic floor disorders.

Methods

This was a secondary analysis of a multicenter study of women with pelvic floor disorders from the USA and UK performed to validate the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR). Participants were surveyed about whether they were sexually active and completed the PISQ-IR and the Female Sexual Function Index (FSFI) questionnaires to assess sexual function. Physical examinations included assessment of pelvic floor strength by the Oxford Grading Scale, and assessment of pelvic floor tone as per ICS guidelines.

Results

The cohort of 585 women was middle-aged (mean age 54.9 ± 12.1) with 395 (67.5 %) reporting sexual activity. Women with a strong pelvic floor (n = 275) were more likely to report sexual activity than women with weak strength (n = 280; 75.3 vs 61.8 %, p < 0.001), but normal or hypoactive pelvic floor tone was not associated with sexual activity (68.8 vs 60.2 %, normal vs hypoactive, p = 0.08). After multivariable analysis, a strong pelvic floor remained predictive of sexual activity (OR 1.89, CI 1.18–3.03, p < 0.01). Among sexually active women (n = 370), a strong pelvic floor was associated with higher scores on the PISQ-IR domain of condition impact (parameter estimate 0.20± 0.09, p = 0.04), and the FSFI orgasm domain (PE 0.51 ± 0.17, p = 0.004).

Conclusion

A strong pelvic floor is associated with higher rates of sexual activity as well as higher sexual function scores on the condition impact domain of the PISQ-IR and the orgasm domain of the FSFI.

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Acknowledgements

We would like to acknowledge Dr Clifford Qualls for his help with the statistical analysis of these data.

Conflicts of interest

G. Kanter: none; R.G. Rogers: DSMB Chair for the TRANSFORM trial sponsored by American Medical Systems, UptoDate royalties; R.N. Pauls: Scientific Advisory Board, Viveve Inc; D. Kammerer-Doak: Committee Chair for the IUGA R&D Committee; R. Thakar: occasional speaker for Astellas, Secretary for IUGA, Honorarium from McGraw-Hill.

Funding

No funding was obtained to support this secondary analysis.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, MSC 10-5580, University of New Mexico, Albuquerque, NM, 87131-0001, USA

    Gregg Kanter

  2. University of New Mexico, Albuquerque, USA

    Rebecca G. Rogers

  3. Good Samaritan Hospital, Cincinnati, OH, USA

    Rachel N. Pauls

  4. Women’s Pelvic Specialty Care, Albuquerque, NM, USA

    Dorothy Kammerer-Doak

  5. FRCOG Croydon University Hospital, Surrey, UK

    Ranee Thakar

Authors
  1. Gregg Kanter
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  2. Rebecca G. Rogers
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  3. Rachel N. Pauls
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  4. Dorothy Kammerer-Doak
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  5. Ranee Thakar
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Corresponding author

Correspondence to Gregg Kanter.

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Kanter, G., Rogers, R.G., Pauls, R.N. et al. A strong pelvic floor is associated with higher rates of sexual activity in women with pelvic floor disorders. Int Urogynecol J 26, 991–996 (2015). https://doi.org/10.1007/s00192-014-2583-7

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  • DOI: https://doi.org/10.1007/s00192-014-2583-7

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